International Journal of Chronic Obstructive Pulmonary Disease最新文献

{"title":"Mitochondrial Mechanisms of Resistance Exercise in COPD-Related Skeletal Muscle Dysfunction: A Narrative Review.","authors":"Yifan Lv, Qian Gao, Xiaoyu Han, Weibing Wu","doi":"10.2147/COPD.S610640","DOIUrl":"https://doi.org/10.2147/COPD.S610640","url":null,"abstract":"<p><p>Chronic obstructive pulmonary disease (COPD) is a heterogeneous pulmonary disorder characterized by airway or alveolar abnormalities. Beyond pulmonary impairment, COPD frequently leads to skeletal muscle dysfunction, manifesting as muscle atrophy, myofibrillar type switching, and reduced muscle strength and endurance, which severely impair exercise capacity and quality of life. Mitochondrial dysfunction, including reduced mitochondrial density, altered respiratory function, and increased oxidative stress, is recognized as a key contributor to skeletal muscle impairment in COPD. Resistance exercise (RE), an effective exercise therapy, has been shown to improve lower-limb muscle function and quality in COPD patients, and it appears feasible even for those with severe airflow obstruction and significant dyspnea. Mechanistically, RE may enhance mitochondrial respiratory capacity and promote mitochondrial biogenesis, and might also counteract mitochondrial dysfunction induced by secondhand smoke. In this narrative review, we analyze the effects of RE on skeletal muscle dysfunction in COPD and summarize the underlying mitochondrial mechanisms.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"610640"},"PeriodicalIF":4.1,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13476677/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148762889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Internal Validation of a Nutrition-Related Indicator-Based Prediction Model for in-Hospital Mortality in Hospitalized Patients with AECOPD.","authors":"Qing Tu, Yi Ding, Fangfang Bai, Qian Li, Yun Zhou, Wenjie Sun, Bangzhu Liu, Zhaoyan Wu, Yeshan Li","doi":"10.2147/COPD.S618346","DOIUrl":"10.2147/COPD.S618346","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the predictive value of routinely available nutrition-related laboratory indicators for in-hospital mortality in hospitalized patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and to develop and internally validate a clinically applicable prediction model.</p><p><strong>Patients and methods: </strong>A retrospective cohort study included 2167 patients hospitalized for AECOPD at the Second People's Hospital of Wuhu between January 1, 2016 and October 21, 2025. Candidate predictors were prespecified based on clinical relevance and previous evidence. Univariable and multivariable logistic regression analyses were performed to identify independent predictors of in-hospital mortality. A prediction model was developed and internally validated using receiver operating characteristic (ROC) analysis, calibration curves with bootstrap resampling, the Hosmer-Lemeshow goodness-of-fit test, and decision curve analysis (DCA).</p><p><strong>Results: </strong>Among the 2167 patients, 109 (5.0%) died during hospitalization. Multivariable analysis identified five independent predictors of in-hospital mortality: older age (OR = 1.234, 95% CI: 1.077-1.422), lower hemoglobin (OR = 1.095, 95% CI: 1.036-1.152), lower albumin (OR = 1.135, 95% CI: 1.083-1.192), respiratory failure at admission (OR = 6.002, 95% CI: 3.936-9.234), and a history of lung cancer (OR = 4.430, 95% CI: 1.815-9.855). The prediction model achieved good discrimination, with an area under the receiver operating characteristic curve (AUC) of 0.811. The calibration curve demonstrated good agreement between predicted and observed outcomes, and the Hosmer-Lemeshow test indicated good model fit (P = 0.196). Decision curve analysis showed that the model provided greater net benefit than both the treat-all and treat-none strategies across a threshold probability range of approximately 5%-50%.</p><p><strong>Conclusion: </strong>We developed and internally validated a simple prediction model incorporating routinely available nutrition-related laboratory indicators and key clinical characteristics for predicting in-hospital mortality in hospitalized patients with AECOPD. The model demonstrated good discrimination and calibration and may serve as a practical bedside tool for early risk stratification and individualized clinical decision-making. External validation in independent multicenter cohorts is warranted before widespread clinical implementation.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"618346"},"PeriodicalIF":4.1,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13459992/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148714221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring Relevance of Graded Sputum Production in Stable COPD in Clinical Practice.","authors":"Laurent Morin, Jean-Christian Borel, Nathalie Arnol, Bernard Aguilaniu","doi":"10.2147/COPD.S626094","DOIUrl":"10.2147/COPD.S626094","url":null,"abstract":"","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"626094"},"PeriodicalIF":4.1,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13459990/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148714219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Methodological Concerns Regarding the Causal Relationship Between Methotrexate and COPD: The Missing Confounding by Indication [Letter].","authors":"Qingqing Shan","doi":"10.2147/COPD.S640052","DOIUrl":"10.2147/COPD.S640052","url":null,"abstract":"","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"640052"},"PeriodicalIF":4.1,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13455821/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148707949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Baseline Blood Eosinophil Count and 28-Day in-Hospital Mortality in ICU-Admitted Patients with AECOPD: A Cohort Study with External Validation.","authors":"Zeqiang Wang, Jianlong Tan, Hanying Liu, Jiangchuan Chen, Lingjia Chen, Weidong Zhang, Wei Liu","doi":"10.2147/COPD.S621415","DOIUrl":"10.2147/COPD.S621415","url":null,"abstract":"<p><strong>Background: </strong>Blood eosinophil count is widely used to guide corticosteroid decisions in stable chronic obstructive pulmonary disease (COPD) and non-ICU acute exacerbations of COPD (AECOPD), but its prognostic value and interpretation in ICU-admitted AECOPD remain uncertain.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using MIMIC-IV as the primary cohort and eICU-CRD for external validation. Adults with AECOPD were included if ICU admission occurred within 24 h of hospital admission and baseline eosinophil count was available within a predefined peri-ICU window. The primary outcome was 28-day in-hospital mortality after ICU admission. Baseline eosinophil count was analyzed per 100 cells/µL increase in prespecified multivariable Cox models.</p><p><strong>Results: </strong>The analytic cohorts included 645 patients from MIMIC-IV and 2503 from eICU-CRD. Twenty-eight-day in-hospital mortality was 14.3% and 6.7%, respectively. In MIMIC-IV, higher baseline eosinophil count was associated with a lower hazard of death (adjusted hazard ratio [HR] per 100 cells/µL: 0.58, 95% confidence interval [CI]: 0.39-0.85; <i>P</i> = 0.005). A similar association was observed in eICU-CRD (adjusted HR: 0.82, 95% CI: 0.72-0.93; <i>P</i> = 0.002). Categorical, competing-risk, and age-restricted analyses were broadly consistent with the primary findings, and restricted cubic splines did not identify a clear threshold.</p><p><strong>Conclusion: </strong>Among ICU-admitted patients with AECOPD who had clinically available baseline eosinophil measurements, higher baseline eosinophil count was associated with lower 28-day in-hospital mortality.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"621415"},"PeriodicalIF":4.1,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13459616/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148714268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low sRAGE Level is Associated with Increased Future Exacerbation Risk in Mild-to-Moderate COPD and Patients with Chronic Bronchitis Symptoms.","authors":"Yutian Zhang, Bi Ran, Hao Wang, Dianmei Zhou, Kai Zi, Zijian Zeng, Xi Yan, Tao Wang, Lei Chen, Tao Ye, Paul Jones, Jun Chen, Fuqiang Wen","doi":"10.2147/COPD.S615390","DOIUrl":"10.2147/COPD.S615390","url":null,"abstract":"<p><strong>Background: </strong>Early identification of patients at high-risk for exacerbation in mild-to-moderate chronic obstructive pulmonary disease (COPD), particularly those with chronic bronchitis (CB) phenotype exhibiting worse outcomes, is critical for slowing lung function decline and reducing the subsequent healthcare burden. While the soluble receptor for advanced glycation end products (sRAGE) correlates with emphysema severity in COPD, in mild-to-moderate COPD or patients with CB symptoms, no prospective investigation has evaluated the association between sRAGE and exacerbation risk.</p><p><strong>Methods: </strong>Sub-cohort data from the COMPASS study, a prospective study in China, were analyzed. Associations between sRAGE levels and exacerbations were assessed treating sRAGE as a continuous variable and categorized into tertile. Negative binomial regression and cox regression were used to assess exacerbation rate and onset time. Subsequent analyses of lung function, COPD Assessment Tool (CAT) score and high-resolution computed tomography (HRCT) parameters were evaluated using linear mixed-effects models based on a cutoff determined by Akaike information criteria (AIC).</p><p><strong>Results: </strong>In the COMPASS sub-cohort, 201 patients had mild-to-moderate COPD and 230 individuals reported CB symptoms. Continuous sRAGE level was not associated with exacerbation risks, but with earlier onset time. In addition, participants in the lowest sRAGE tertile exhibited significant shorter time to first exacerbation in both populations. The lowest tertile was also associated with increased exacerbation risks in patients with CB and showed a borderline significant association in patients with mild-to-moderate COPD. No significant differences in lung function decline, HRCT changes, or CAT score progression were observed between the low- and high-sRAGE groups.</p><p><strong>Conclusion: </strong>Lower sRAGE level may be associated with an increased exacerbation risk in mild-to-moderate COPD and in patients with CB symptoms. Blood sRAGE is a candidate biomarker for identifying subgroups at higher exacerbation risk in populations at high risk of disease progression.</p><p><strong>Clinical trial registration: </strong>Clinicaltrials.gov identifier NCT04853225; GSK study code 208630.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"615390"},"PeriodicalIF":4.1,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13450083/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148698089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal Outcomes and Prognostic Risk of Normalized Airflow Obstruction in a Korean General Population Cohort.","authors":"Yun Seok Kim, Yong Suk Jo, Chin Kook Rhee, John S Kim, Yet Hong Khor, Joon Young Choi","doi":"10.2147/COPD.S614948","DOIUrl":"10.2147/COPD.S614948","url":null,"abstract":"<p><strong>Introduction: </strong>Some individuals with airflow obstruction later show normalized spirometric values, but the clinical implications of this phenomenon in the general population are unclear.</p><p><strong>Methods: </strong>Using data from the Korean Genome and Epidemiology Study (KoGES), we examined the characteristics and prognosis of individuals with normalized airflow obstruction (NO), defined as FEV1/FVC <0.7 at baseline that normalized to ≥0.7 during follow-up.</p><p><strong>Results: </strong>Between 2000 and 2006, 4,807 participants were classified as NO (n=242), fixed obstruction (FO; persistent FEV1/FVC <0.7; n=277), or normal (FEV1/FVC ≥0.7 throughout; n=4,288). Over eight years of follow-up (2007-2014), the NO group contained more men, current smokers, and individuals with lower body mass index than the normal group and showed intermediate lung function between FO and normal groups. Annual FEV1 decline was similar across groups (-48.8 mL/year normal; -48.3 mL/year NO; -45.8 mL/year FO). However, by the end of the 12-year follow-up period, 37.2% of participants in the NO group developed airflow obstruction, with a 4.22-fold higher risk compared with the normal group (95% CI 3.26-5.46). Findings were consistent in a sensitivity analysis excluding individuals with excessive lung function variability. (HR 7.41, 95% CI 5.45-10.07).</p><p><strong>Discussion: </strong>These findings indicate that NO may represent a distinct and dynamic spirometric phenotype associated with increased risk of future airflow obstruction and highlight the need for early identification and preventive strategies in at-risk populations.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"614948"},"PeriodicalIF":4.1,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13436087/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148674532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"28-Day Mortality and Prognostic Factors in COPD Patients with Sepsis: A Retrospective Study Using eICU-CRD Database.","authors":"Ailing Zhu, Wei Sun, Dehai Ge, Xiujian Zhang, Jinfeng Zhang, Manman Hu, Qiangjian Zhong, Yangchun Wang, Junjun Liu","doi":"10.2147/COPD.S622249","DOIUrl":"10.2147/COPD.S622249","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) is the third leading global cause of death, and concurrent sepsis markedly increases short-term mortality, making early identification of high-risk patients clinically essential. This retrospective study, based on the multi-center eICU-CRD database, sought to identify independent predictors of 28-day all-cause mortality and develop a combined prognostic model for intensive care unit (ICU) patients complicated with both COPD and sepsis.</p><p><strong>Methods: </strong>A total of 1814 eligible patients (49.4% male, mean age 70.03 ± 11.20 years) from 208 US ICUs (2014-2015) were included. Baseline demographic, vital, laboratory, blood gas and organ function data within 24 h of admission were collected. Univariate and multivariate Cox regression screened independent prognostic factors, and ROC curves evaluated predictive performance of single markers and the integrated model.</p><p><strong>Results: </strong>28-day mortality among sepsis-COPD patients was 9.2% (166/1814). After adjusting for confounding variables, the sequential organ failure assessment (SOFA) score was proven to independently affect mortality (HR = 1.19, 95% CI 1.08-1.30, P < 0.001). In contrast, pH (HR = 0.08, 95% CI 0.01-0.96) and body mass index (BMI) (HR = 0.96, 95% CI 0.932-0.998) showed protective effects. All included predictors had area under the curve (AUC) values between 0.57 and 0.67, and the SOFA score achieved the maximum predictive performance. A combined risk model integrating these variables achieved an AUC of 0.70 (95% CI 0.65-0.75, P < 0.001), showing satisfactory discriminatory power. At a threshold value of 0.166 for predictive probability, the model obtained 0.514 sensitivity and 0.791 specificity.</p><p><strong>Conclusion: </strong>Higher SOFA, lower pH and lower BMI independently predict worse 28-day survival in ICU COPD-sepsis patients. This integrated model exhibits moderate discriminative ability and can serve as an auxiliary tool for rapid risk screening among ICU patients.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"622249"},"PeriodicalIF":4.1,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13431427/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148670946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Influencing Team-Based Vaccination Collaboration in Chronic Obstructive Pulmonary Disease: A Multicenter Cross-Sectional Survey of Primary Care Teams in Beijing, China.","authors":"Yifan Hou, Ping Zhao, Yuzhe Shi, Meng Ren, Jing Hai, Yang Zhao, Na Zhang, Zhou Wang, Yi Qian, Xu Yang","doi":"10.2147/COPD.S596737","DOIUrl":"10.2147/COPD.S596737","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to investigate the factors influencing the impact of healthcare team collaboration on vaccination status among patients with Chronic Obstructive Pulmonary Disease (COPD) in primary care settings in Beijing, China.</p><p><strong>Patients and methods: </strong>A multicenter cross-sectional survey was conducted among members of family doctor teams in Beijing from October to December 2025. A structured questionnaire assessed team collaboration behaviors, influencing factors, guideline awareness, and vaccination practices. Descriptive statistics and chi-square tests were performed.</p><p><strong>Results: </strong>A total of 209 valid responses were included (response rate: 92.07%). Although 57.9% of participants supported shared responsibility for vaccination, only 24.9% reported frequent team discussions, and 9.1% reported none in the past three months. Unstable vaccine supply (M=2.83) and limited performance incentives (M=3.76) were key barriers. While 66.5% of respondents were familiar with relevant guidelines, only 44.5% consistently provided strong vaccination recommendations in clinical scenarios. Patient hesitancy was primarily attributed to concerns about side effects (69.4%). Most respondents (67.0%) estimated vaccination coverage among COPD patients to be below 30%.</p><p><strong>Conclusion: </strong>A substantial gap exists between guideline awareness and implementation of vaccination in primary care COPD management. Limited team communication, inadequate system support, and patient hesitancy jointly constrain vaccination uptake. Strengthening structured team collaboration, improving incentive mechanisms, and enhancing scenario-based guideline training may help improve vaccination coverage in this population.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"596737"},"PeriodicalIF":4.1,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13426348/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148654745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying the Challenges in Self-Management and Preferences for Digital Health Technologies Use Among COPD Patients Based on the CeHRes Roadmap: A Formative Qualitative Study.","authors":"Guo-Fang Tao, Su Yang, Luqing Gao, Xiting Huang, Lihua Huang","doi":"10.2147/COPD.S623363","DOIUrl":"10.2147/COPD.S623363","url":null,"abstract":"<p><strong>Background: </strong>Digital health technologies offer a promising approach to strengthening self-management capacity among patients with chronic obstructive pulmonary disease (COPD), yet clinical application is hampered by poor adherence, low sustained engagement, and limited self-management ability. Although previous studies have identified general self-management challenges in COPD, few have systematically investigated patients' preferences for digital tools or translated these insights into actionable design principles. This hinders the user-centred development and effective deployment of digital interventions for this population.</p><p><strong>Objective: </strong>This study aimed to explore the self‑management challenges and preferences for mobile health (mHealth) among COPD patients, with the ultimate goal of translating these findings into design principles for a persuasive self‑management application.</p><p><strong>Methods: </strong>We conducted in-depth personal interviews with 15 patients with COPD and five healthcare professionals to explore the challenges of self-management and preferences for mHealth. Data were analyzed using thematic analysis. Subsequently, a structured expert consultation was held to translate the findings into key principles for a persuasive self-management application.</p><p><strong>Results: </strong>Five themes regarding barriers to effective self-management were identified: (1) negative emotional experience, (2) poor health literacy, (3) insufficient family support, (4) inadequate professional health care, and (5) economic burden. Patients expressed four key preferences for digital health technologies: (1) simplicity, (2) personalized decision support, (3) self-report, (4) early warning of deterioration. Furthermore, the panel discussion distilled these findings into eight essential key principles: motivation, simplicity, credibility, guidance, personalization, self-report, warning, and continuity.</p><p><strong>Conclusion: </strong>This study provides new insights into user-centered mHealth tools for COPD self-management. We derived core design principles from patients' demands to inform targeted digital interventions. These principles require validation in female, higher-literacy and multi-center samples before wide application. Future work will complete the remaining CeHRes Roadmap stages of design, operationalization and evaluation to refine this framework.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"623363"},"PeriodicalIF":4.1,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13428098/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148654777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}